RT Journal Article
SR 00
ID 10.1016/j.ijcard.2024.132036
A1 Espersen, Caroline
A1 Campbell, Ross T.
A1 Claggett, Brian L.
A1 Lewis, Eldrin F.
A1 Docherty, Kieran F.
A1 Lee, Matthew M.Y.
A1 Lindner, Moritz
A1 Brainin, Philip
A1 Biering-Sørensen, Tor
A1 Solomon, Scott D
A1 McMurray, John J.V.
A1 Platz, Elke
T1 Predictors of heart failure readmission and all-cause mortality in patients with acute heart failure
JF International Journal of Cardiology
YR 2024
FD 2024-07-01
VO 406
K1 acute heart failure, risk score, lung ultrasound, echocardiography.
AB Background  Predischarge risk stratification of patients with acute heart failure (AHF) could facilitate tailored treatment and follow-up, however, simple scores to predict short-term risk for HF readmission or death are lacking.    Methods  We sought to develop a congestion-focused risk score using data from a prospective, two-center observational study in adults hospitalized for AHF. Laboratory data were collected on admission. Patients underwent physical examination, 4-zone, and in a subset 8-zone, lung ultrasound (LUS), and echocardiography at baseline. A second LUS was performed before discharge in a subset of patients. The primary endpoint was the composite of HF hospitalization or all-cause death.    Results  Among 350 patients (median age 75 years, 43% women), 88 participants (25%) were hospitalized or died within 90 days after discharge. A stepwise Cox regression model selected four significant independent predictors of the composite outcome, and each was assigned points proportional to its regression coefficient: NT-proBNP ≥2000 pg/mL (admission) (3 points), systolic blood pressure < 120 mmHg (baseline) (2 points), left atrial volume index ≥60 mL/m2 (baseline) (1 point) and ≥ 9 B-lines on predischarge 4-zone LUS (3 points). This risk score provided adequate risk discrimination for the composite outcome (HR 1.48 per 1 point increase, 95% confidence interval: 1.32–1.67, p < 0.001, C-statistic: 0.70). In a subset of patients with 8-zone LUS data (n = 176), results were similar (C-statistic: 0.72).    Conclusions  A four-variable risk score integrating clinical, laboratory and ultrasound data may provide a simple approach for risk discrimination for 90-day adverse outcomes in patients with AHF if validated in future investigations.
NO This work was supported by U.S. National Institutes of Health/National Heart, Lung and Blood Institute (NIH/NHLBI) grant  K23HL123533) (to Dr. Platz) and project grant PG/13/17/30050 (to  Drs. Campbell and McMurray) from the British Heart Foundation.
PB Elsevier
SN 0167-5273
LK https://eprints.gla.ac.uk/324955/